February 27, 2019
After years of arguing that people didn’t need to worry about increasing e-cig use among kids in England, because of the different (from the USA) regulatory environment, e-cig cheerleading Public Health England announced e-cig use among kids doubled in the last 4 years. And that was before Juul invaded.
As expected, the Public Health England (a government agency) minimized the effect, as did, ASH England and other e-cig enthusiasts minimized this huge increase on the grounds that few kids were “regular” e-cig users. This argument ignores the fact that the evidence (collected by e-cig enthusiasts!) shows that among kids who use tobacco in England, more than half are initiating nicotine use with e-cigs and any e-cig use predicts future smoking. Indeed, the “gateway” effect in England is about 12, compared to 3-4 in the USA.
And even if the kids did not add cigarettes later, bathing developing brains in nicotine is a very bad thing because the neurological changes are permanent.
February 24, 2019
Dharma Bhatta and I presented this abstract at the 2019 Society for Research on Nicotine and Tobacco meeting. It shows about the same risks as the earlier studies. This is also exactly what one would expect to happen based on the biological effects that e-cigs have on blood vessels and platelets.
POS4-99
ELECTRONIC CIGARETTE USE AND MYOCARDIAL INFARCTION AMONG ADULTS IN THE UNITED STATES POPULATION ASSESSMENT OF TOBACCO AND HEALTH
Dharma N. Bhatta, PhD, MPH, Stanton Glantz, PhD. University of California San Francisco, San Francisco, CA, USA.
Background: Electronic cigarettes are battery operated nicotine delivery devices, popular for smoking cessation tools and as an alternative product to combustible cigarettes. This study aim is to determine the association between electronic cigarette use and myocardial infarction.
Methods: Adults age 18 and older at Wave 1 (n = 32,320; 2013-2014) and Wave 2 (n=26,447; 2014-2015) of the Population Assessment of Tobacco and Health (PATH) study in the United States of America were used. Multivariable logistic regression was performed to determine the associations between e-cigarette use and myocardial infarction, adjusting for cigarette smoking, demographic and clinical variables.
February 24, 2019
Three more epidemiological studies demonstrating increased risk of lung disease in e-cigarette users were presented at the Society for Nicotine and Tobacco Research meeting from Feb 20-23, 2019. While they use different end points (respiratory disease generally, asthma, or COPD), they all show elevated risks associated with e-cigarette use, either by using people who are only using e-cigs or accounting for smoking in the statistical analysis.
These epidemiological changes are precisely what you would predict based on the pathological changes that e-cigs cause in the lungs.
Here are the abstracts:
POS2-146
ELECTRONIC CIGARETTE USE IS ASSOCIATED WITH RESPIRATORY DISEASE AMONG ADULTS IN THE UNITED STATES POPULATION ASSESSMENT OF TOBACCO AND HEALTH: A LONGITUDINAL ANALYSIS
Dharma N. Bhatta, PhD, Stanton Glantz, PhD. University of California San Francisco, San Francisco, CA, USA.
February 24, 2019
There were several interesting scientific presentations at the Society for Research on Nicotine and Tobacco meeting held from February 20-23, 2019 in San Francisco dealing with the biology of how e-cigarettes cause disease. It is becoming clearer and clearer that e-cigarettes are not just cigarettes that deliver less of some bad things, which is how everyone, including me, used to think about them. The reality is that e-cigarettes are different from cigarettes. While they damage the body through some mechanisms in common with cigarettes, it is now clear that e-cigarettes also have adverse effects through channels not affected by cigarettes (and vice versa). The effects even transcend generations; exposure while pregnant compromises blood function in adult offspring.
These effects occur at the levels of exposure that real-world e-cigarettes generate and can be substantial. Evidence is also appearing demonstrating that e-cigarettes are implicated in cancer, something most people, including me, previously did not think was a substantial risk.
February 16, 2019
Pawan Sharma and colleagues recently published “IQOS exposure impairs human airway cell homeostasis: direct comparison with traditional cigarette and e-cigarette” in which they measured a wide range of effects of cigarette smoke extract (from Philip Morris’ Marlboro cigarettes, Philip Morris International’s heated tobacco product IQOS, and an e-cig using Blu liquid) on human lung cells. All three products adversely affected lung cells with a dose-response (i.e., bigger effects at higher doses).
In this study they exposed lung from the lining of the bronchi (big air pipes) and airway smooth muscle cells in vitro (i.e., cells in “test tubes”) to solutions made from the aerosols from all three products.
Here is my simplified version of their summary: